Professional Fee Coder/Auditor

What We Strive For 

At Strive Health, we’re driven by a purpose: transforming the broken kidney care system. Through early identification, engagement, and comprehensive coordinated care, we significantly improve outcomes for people with kidney disease, reducing emergency dialysis and inpatient utilization. Our high-touch care model integrates with local providers and uses predictive data to identify and support at-risk patients along their entire care journey. We embrace diversity, celebrate successes, and support each other, making Strive the destination for top talent in healthcare. Join us in making a real difference. 

Benefits & Perks 

• Hybrid-Remote Flexibility – Work from home while fulfilling in-person needs at the office, clinic, or patient home visits.
• Comprehensive Benefits – Medical, dental, and vision insurance, employee assistance programs, employer-paid and voluntary life and disability insurance, plus health and flexible spending accounts. 
• Financial & Retirement Support – Competitive compensation with a performance-based discretionary bonus program, 401k with employer match, and financial wellness resources.
• Time Off & Leave – Paid holidays, flexible vacation time, sick time, and paid birthgiving, bonding, sabbatical, and living donor leaves.
• Wellness & Growth – Family forming services through Maven Maternity at no cost and physical wellness perks, mental health support, and an annual professional development stipend. 
  

What You’ll Do 

This position is responsible for Coding and Auditing Professional Fee records to determine the appropriate designation of diagnosis and procedure codes while maintaining compliance with Official Coding Guidelines. The Professional Fee Coder and Auditor is responsible for preparing the claim prior to claim submission which includes but is not limited to validation of patient demographics, insurance and carrier assignment, financial class and other pertinent data fields to ensure the claim is attached to the correct Provider Billing Group classification. During the coding/auditing process, the Professional Fee Coder and Auditor may indicate a provider inquiry or feedback needed and will compose physician-friendly verbiage following prescribed workflow. This position reports to the Manager, Revenue Cycle Management. 

The Day to Day 

• Analyzes, evaluates, and reviews medical records to ensure accuracy of code assignment. Codes professional fee charts and/or validates clinical code assignment (as needed per market). 
• Utilizes expertise in coding or auditing Renal Specialty of professional fee and be able to code, audit, or train others accordingly  
• Prepares Physician Inquiries and/or provides feedback related to code validation audits or other reviews. 
• Prepares daily coding logs, independently track sproduction for review, and maintains a coding production rate of 95% or above. 
• Demonstrates proficiency in coding including both ICD-10 and CPT while maintaining 95% accuracy or above. 
• Conducts claim editing activities, troubleshoots problem accounts, and conducts root cause analysis, following escalation pathway to RCM Leadership as applicable. 

Minimum Qualifications 

• 5 years combined of related education, experience, or certification. 
• Approved credential from AHIMA or AAPC (ex. Certified Professional Coder). 
• Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms. 
• Ability to travel and be on-site to meet business needs.

Preferred Qualifications 

• Expertise in Risk Adjustment Coding. 
• HCC Certified Coding Credential. 
• Create Physician-friendly, compliant verbiage for provider feedback processes. 
• Skilled in Microsoft Office applications. 

About You 

• Proven ability to be successful in an autonomous work environment. 
• Experience in a startup, renal care or value-based care environment. 
• Excellent written and/or verbal communication, analytical skills and demonstrate ability to think critically and operate autonomously. 

Annual Base Salary Range: $66,000 - $77,000

Strive Health is an equal opportunity employer and drug free workplace. At this time Strive Health is unable to provide work visa sponsorship. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Please apply even if you feel you do not meet all the qualifications. If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talentacquisition@strivehealth.com.

We do not accept unsolicited resumes from outside recruiters/placement agencies. Strive Health will not pay fees associated with resumes presented through unsolicited means.

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